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hhp <br />FtECEIVE® <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />/ANNiiAi. FF.F, and RF.Pl1RT RF.~jTFST <br />/ Summit Brick & Tile Co. <br />~M-1977-324 <br />Stocks Clay Mine <br />February 17,2006 <br />~~FEB 2 1 2006 <br />~ pivision of Minerals anJ Geology <br />$688.00 (Due on or before your anniversary date) <br />Fremont <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall_sulzmit~he-anaual~ee _a_report_and_map_ showing. the extent of currentdisturbances_to. affected_land,__ <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />pl ae ce~ttarh ynnr ravised written anneal report and anneal report m n this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Joseph C. Welte <br />Permittee Name: Summit Brick & Tile Co. <br />Address: P.O. Box 533 <br />Pueblo, CO 81002-0533 <br />Phone Number: (719} 542-8278 <br />Fax Number: (719) 542-5243 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Si tur of Corporate'Of^ficer/, weer, or Designee <br />o~ ~ ~ y/CJ,(~ <br />Date <br />